Knee and Hip pain: non-surgical treatment recommendations are often not followed | Prolotherapy.org

Despite guidelines that suggest to doctors that they recommend non-surgical options to patients possibly facing knee and hip replacement, researchers say the non-surgical treatment recommendations are often not followed or even overlooked.

Evidence-based guidelines for hip and knee osteoarthritis recommend that patients start with non-surgical treatments, followed by surgical intervention if a patient does not respond sufficiently to non-surgical treatments, but there are indications that these are not optimally used. New research assesses the extent to which all recommended non-surgical treatments were used by patients with hip or knee osteoarthritis who receive(d) a total hip or knee replacement, as reported by patients and surgeons.

One-hundred ninety-five osteoarthritis patients who had undergone total knee arthroplasty or total hip arthroplasty no longer than 12 months ago or being on the waiting list for surgery with a confirmed date within 3 months and 482 orthopaedic surgeons were invited to participate.

Most recommended non-surgical treatments were given to the majority of patients (eg, 80% education about osteoarthritis, 73% physical therapy, 72% acetaminophen, 80% NSAIDs).

However, only 6% of patients and 10% of orthopaedic surgeons reported using a combination of all recommended treatments.

Dietary therapy was used least frequently.

Only 11% of overweight and 30% of obese participants reported having received dietary therapy and 28% of orthopaedic surgeons reported to prescribe dietary therapy to overweight patients.

While most recommended non-surgical treatments were used frequently as single therapy, the combination is used in only a small percentage of osteoarthritis patients. Especially, use of dietary therapy may be improved to help patients manage their symptoms, and potentially delay the need for joint arthroplasty.